Salvage surgery for radiation failure in prostate cancer.

Author(s):Pontes JE, Montie J, Klein E, Huben R

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Abstract METHODS: Salvage surgery was done in 43 patients who did not respond to radiation therapy of prostate cancer between 1982-1991. Thirty-five patients underwent salvage prostatectomy and 8, cystoprostatectomy. RESULTS: The complications were significant; four patients had rectal injuries (all closed primarily), one had a ureteral injury, and there was one perioperative death. Urinary incontinence occurred in 10 of 35 patients (30\%). Pathologic step sections of the prostate showed that only 13 of 43 patients (30\%) had negative surgical margins. Follow-up (range, 1-10 years) revealed that 34 patients were alive, and 9 had died. Eleven of 20 patients were alive who were followed more than 5 years. Ten patients were considered to have no evidence of disease (undetectable prostate specific antigen levels). CONCLUSION: In selected patients, salvage surgery has a place in the treatment of prostate cancer after radiation therapy failure.

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